SALT LAKE CITY -- With federal approval in hand for its unique split-model health insurance exchange, Utah officials began shifting their focus Thursday to what needs to be done so the marketplaces are ready for open enrollment on Oct. 1.
The federal government agreed last week to allow Utah to become the first state to use a model in which the state continues to run its existing health insurance marketplace for small businesses while the federal government runs the state's individual exchange.
Other states will have the option to consider this model after the U.S. Health and Human Services approves an official rule, a process that usually takes several months, allowing Utah's deal to go forward.
On Thursday, Utah's legislative health reform task force heard from several state officials about what lies ahead over the next four-plus months.
Patti Conner, director of the state's existing small business health insurance exchange, said to be compliant with the federal health overhaul, the online marketplace needs a revamping of the technology used to run it; creation of a Spanish-language website; and integration of two federally mandated navigators to help consumers find the best plans.
While one legislator compared the work to getting ready to move into a new house, Conner assured him the tasks are more like putting new carpet down to give a home a new look and that they will be done in time for open enrollment.
The exchange, called Avenue H, has been up and running since 2009. It lets employees of participating companies pick health care plans in an online exchange. The marketplace now serves 344 employers that provide insurance to about 8,000 people.
Legislators on the panel had many questions about how the individual marketplace -- which could be tapped into by as many 270,000 Utah residents -- will be run and operated by the federal government. Answers, however, were in short supply.
Conner told them the federal officials have been tight-lipped about their plans other than assuring her the individual exchange will function, but may not be pretty.
The U.S. government must get online health insurance marketplaces ready for 26 other states as well.
The chairman of the health care reform task force, Rep. James Dunnigan, R-Taylorsville, said he has concerns about how Utah agencies will interface with the federally run part of the exchange. Since the state has to determine people's Medicaid eligibility, there will need to be personal information exchanged back-and-forth, he said.
"I'm worried about data breaches," Dunnigan said. "And frankly, I don't think the federal government is going to have a very good exchange."
Conner said the state plans to market Avenue H and tell people to be cautious before leaving that program for the individual exchange. Even though they may be enticed by financial assistance, they may not end up qualifying, she said.
Jason Stevenson, education and communication director for the Utah Health Policy Project, a nonpartisan, nonprofit health research and advocacy organization, said he worries the state's efforts to promote Avenue H could result in residents not getting enough information about the individual exchange.
The number of people who will benefit from the individual exchange will likely greatly outnumber those participating in the small business marketplace, Stevenson said.
"I worry that there is going to be a little bit of a tug of war between the state and feds over where people should go to buy insurance."